The Experts below are selected from a list of 1881 Experts worldwide ranked by ideXlab platform
Saima Sharif - One of the best experts on this subject based on the ideXlab platform.
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the incidence of Arm Edema in women with breast cancer randomized on the national surgical adjuvant breast and bowel project study b 04 to radical mastectomy versus total mastectomy and radiotherapy versus total mastectomy alone
International Journal of Radiation Oncology Biology Physics, 2004Co-Authors: Melvin Deutsch, Stephanie R Land, Mirsada Begovic, Saima SharifAbstract:Purpose To determine the incidence and factors associated with the development of Arm Edema in women who participated in the National Surgical Adjuvant Breast and Bowel Project (NSABP) study B-04. Methods and Materials Between 1971 and 1974, the NSABP protocol B-04 randomized 1,665 eligible patients with resectable breast cancer to either ( 1 ) the Halstead-type radical mastectomy; ( 2 ) total mastectomy and radiotherapy to the chest wall, axilla, supraclavicular region, and internal mammary nodes if by clinical examination axillary nodes were involved by tumor; and ( 3 ) for patients with a clinically uninvolved axilla, a third Arm, total mastectomy alone. Measurements of the ipsilateral and contralateral Arm circumferences were to be performed every 3 months. Results There was at least one recorded measurement of Arm circumferences for 1,457 patients (87.5% of eligible patients). There were 674 women (46.3%) who experienced Arm Edema at some point during the period of follow-up until February 1976. For radical mastectomy patients, total mastectomy and radiotherapy patients, and total mastectomy patients alone, Arm Edema was recorded at least once in 58.1%, 38.2%, and 39.1% of patients, respectively (p p = p = .001) and at last assessment ( p = .005). Conclusions Patients who undergo mastectomy, including those whose treatment plans do not include axillary dissection or postoperative radiotherapy, suffer an appreciable incidence of Arm Edema.
Gabriel M Danovitch - One of the best experts on this subject based on the ideXlab platform.
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pleural effusion associated with ipsilateral breast and Arm Edema as a complication of subclavian vein catheterization and arteriovenous fistula formation for hemodialysis
Chest, 1994Co-Authors: Robert S Wright, William J Quinonesbaldrich, Alpha J Anders, Gabriel M DanovitchAbstract:A 38-year-old woman with end-stage kidney disease presented with a pleural effusion and profound Edema of the ipsilateral Arm and breast. A patent hemodialysis arteriovenous fistula access was present in the involved extremity. Brachiocephalic vein stenosis, as a result of previous dialysis catheter placement in the subclavian vein, was demonstrated by ultrasound imaging and Doppler analysis. Takedown of the arteriovenous fistula in the Edematous Arm along with living-related kidney transplantation caused immediate resolution of the breast and Arm Edema and rapid clearing of the effusion. An anatomic explanation for the findings is offered.
Melvin Deutsch - One of the best experts on this subject based on the ideXlab platform.
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the incidence of Arm Edema in women with breast cancer randomized on the national surgical adjuvant breast and bowel project study b 04 to radical mastectomy versus total mastectomy and radiotherapy versus total mastectomy alone
International Journal of Radiation Oncology Biology Physics, 2004Co-Authors: Melvin Deutsch, Stephanie R Land, Mirsada Begovic, Saima SharifAbstract:Purpose To determine the incidence and factors associated with the development of Arm Edema in women who participated in the National Surgical Adjuvant Breast and Bowel Project (NSABP) study B-04. Methods and Materials Between 1971 and 1974, the NSABP protocol B-04 randomized 1,665 eligible patients with resectable breast cancer to either ( 1 ) the Halstead-type radical mastectomy; ( 2 ) total mastectomy and radiotherapy to the chest wall, axilla, supraclavicular region, and internal mammary nodes if by clinical examination axillary nodes were involved by tumor; and ( 3 ) for patients with a clinically uninvolved axilla, a third Arm, total mastectomy alone. Measurements of the ipsilateral and contralateral Arm circumferences were to be performed every 3 months. Results There was at least one recorded measurement of Arm circumferences for 1,457 patients (87.5% of eligible patients). There were 674 women (46.3%) who experienced Arm Edema at some point during the period of follow-up until February 1976. For radical mastectomy patients, total mastectomy and radiotherapy patients, and total mastectomy patients alone, Arm Edema was recorded at least once in 58.1%, 38.2%, and 39.1% of patients, respectively (p p = p = .001) and at last assessment ( p = .005). Conclusions Patients who undergo mastectomy, including those whose treatment plans do not include axillary dissection or postoperative radiotherapy, suffer an appreciable incidence of Arm Edema.
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Arm Edema after lumpectomy and breast irradiation
American Journal of Clinical Oncology, 2003Co-Authors: Melvin Deutsch, John C. FlickingerAbstract:Ipsilateral Arm Edema can be a troublesome adverse sequel of breast conservation therapy. We carried out a prospective study of Arm Edema in every patient (265) seen during a 6-month period for follow-up after radiotherapy postlumpectomy for unilateral primary breast cancer. One hundred eighty-one (
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Arm Edema after Lumpectomy and Breast Irradiation: 11:00 Am (15)
The Cancer Journal, 2002Co-Authors: Melvin Deutsch, John C. FlickingerAbstract:Purpose: To determine patient and treatment factors associated with the development of Arm Edema following lumpectomy +/− axillary dissection and breast irradiation for unilateral breast carcinoma. Materials and Methods: Two hundred sixty-five (265) women who presented for followup in a six month period after having been treated with lumpectomy +/- axillary dissection and post-operative breast irradiation for unilateral breast cancer were evaluated carefully by a single physician for the presence of Arm Edema. The median age at time of surgery was 61 years (range 28–85 years). At the time of evaluation, the followup interval from surgery ranged from 3–249 months (median 70). Lumpectomy was the surgical procedure in 84, whereas 181 had lumpectomy and axillary dissection. All patients were treated with whole breast irradiation using two opposed parallel tangential beams. Only eight patients (3%) were treated with additional radiotherapy to at least one nodal area. Adjuvant systemic therapy was administered to 188 patients. Tamoxifen alone was the treatment for 127 (47.9%) and 60 patients (22.6%) were treated with chemotherapy +/- Tamoxifen. Results: Arm Edema was present in 19 patients (7.2%). By multi-variate analysis, there were three factors which correlated with the development of Arm Edema: Increased weight, P = 0.0016, axillary dissection, P = 0.0446, and the administration of Tamoxifen, P = 0.0385. All cases of Arm Edema were considered to be either mild or moderate. There were no severe cases with associated functional impairments. Conclusions: Arm Edema after lumpectomy +/- axillary dissection and breast irradiation is a relatively rare occurrence, especially if the axilla is not irradiated after an axillary dissection. The Edema usually is mild and is just an adverse cosmetic sequelae without functional impairments.
Simon N Powell - One of the best experts on this subject based on the ideXlab platform.
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localized therapy for male breast cancer functional advantages with comparable outcomes using breast conservation
Clinical Breast Cancer, 2013Co-Authors: Shannon Fogh, Saveli Goldberg, Alphonse G Taghian, Simon N Powell, Lisa A Kachnic, Ariel E HirschAbstract:Abstract Background Male breast cancer (MBC) accounts for approximately 1% of all breast cancers. Given the rarity of this disease, treatment of MBC generally follows the same principles as treatment of female breast cancer. However, the traditional surgical approach for MBC is modified radical mastectomy (MRM) or total simple mastectomy (TSM) instead of breast conservation surgery (BCS). The purpose of this study was to examine the feasibility of BCS as an alternative to mastectomy for MBC with respect to musculoskeletal functionality and treatment outcome. Patients and Methods A retrospective analysis was undertaken of all male patients with breast cancer who presented to Massachusetts General Hospital or Boston Medical Center for localized therapy from 1990 to 2003. Musculoskeletal functionality (tissue fibrosis, Arm Edema, and range of motion) and treatment outcome (local-regional control, disease-free survival, and overall survival) were evaluated. Functional/cosmetic outcomes were assessed by multidisciplinary review of patient follow-up visits and were scored as either “good-excellent” or “fair-poor” to account for subjectivity between different clinicians. Results Forty-two patients in total were identified to undergo localized treatment. Thirty patients (71%) received MRM, 4 (10%) had TSM, and 8 (19%) underwent BCS. Actuarial overall 1-year fair-poor documented tissue fibrosis, Arm Edema, and decreased range of motion rates were 13%, 23%, and 27% for patients receiving MRM; 25%, 0%, and 50% for patients who underwent TSM; and 13%, 0%, and 0% for those undergoing BCS, respectively. Overall survival and disease-free survival were not statistically different between the groups. Conclusions These data suggest that breast conservation therapy may be considered a reasonable local treatment option for male patients presenting with breast cancer because it may offer functional advantages over mastectomy with comparable rates of local control and disease-free survival and overall survival.
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risk of lymphEdema after regional nodal irradiation with breast conservation therapy
International Journal of Radiation Oncology Biology Physics, 2003Co-Authors: Simon N Powell, Alphonse G Taghian, Lisa A Kachnic, John J Coen, Sherif I AssaadAbstract:Abstract Purpose To evaluate the risk factors for lymphEdema in patients receiving breast conservation therapy for early-stage breast cancer. Methods and materials Between 1982 and 1995, 727 Stage I–II breast cancer patients were treated with breast conservation therapy at Massachusetts General Hospital. A retrospective analysis of the development of persistent Arm Edema was performed. LymphEdema was defined as a >2-cm difference in foreArm circumference compared with the untreated side. The median follow-up was 72 months. Breast and regional nodal irradiation (BRNI) was administered in 32% of the cases and breast irradiation alone in 68%. Results Persistent Arm lymphEdema was documented in 21 patients. The 10-year actuarial incidence was 4.1%. The median time to Edema was 39 months. The only significant risk factor for lymphEdema was BRNI. The 10-year risk was 1.8% for breast irradiation alone vs. 8.9% for BRNI ( p = 0.001). The extent of axillary dissection did not predict for lymphEdema even within the subgroups of patients defined by the extent of irradiation. Most patients underwent Level I or II dissection. In this subgroup, the lymphEdema risk at 10 years was 10.7% for BRNI vs. 1.0% for breast irradiation alone ( p = 0.0003). Conclusion Nodal irradiation was the only significant risk factor for Arm lymphEdema in patients receiving breast conservation therapy for early-stage breast cancer. Our data suggest that this risk is low with Level I/II dissection and breast irradiation. However, even after the addition of radiotherapy to the axilla and supraclavicular fossa, the development of lymphEdema was only 1 in 10, lower than generally recognized.
A W Rademacker - One of the best experts on this subject based on the ideXlab platform.
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early stage breast cancer Arm Edema after wide excision and breast irradiation
Radiology, 1996Co-Authors: K D Kiel, A W RademackerAbstract:PURPOSE: To determine the incidence of Arm Edema in women with early-stage breast cancer after breast-conserving surgery and irradiation. MATERIALS AND METHODS: Women aged 29-83 years (mean, 55.9 years) treated with breast-conserving surgery and irradiation (n = 183) underwent a series of measurements of the circumference of each Arm. Patient and treatment factors were analyzed for predictive value. RESULTS: Arm Edema developed in 35.0% (n = 64), and clinically significant Edema developed in 17.5% (n = 32) of patients. Dissections that yielded 16 or more nodes led to a 44% actuarial incidence of Edema and a 29% actuarial incidence of clinically significant Edema. Clinically significant Arm changes occurred in 19 of the 87 (22%) women older than 55 years and in 13 of the 96 (14%) women younger than 55 years (P = .002). Chemotherapy, breast radiation dose, and use of tamoxifen had no effect on development of Edema. CONCLUSION: Axillary dissection producing more than 15 nodes and age older than 55 years are ...